Key result
S-ICD linked to lower anxiety but similar quality of life and depression vs TV-ICD.
Why the study?
Although use of the subcutaneous implantable defibrillator has increased, little is known about whether patient quality of life is comparable between subcutaneous and transvenous devices.
Does a subcutaneous implantable defibrillator improve quality of life, depression, and anxiety compared to a transvenous defibrillator in patients requiring an ICD?
Cohort (n=334)
Yes
Does a subcutaneous implantable defibrillator improve quality of life, depression, and anxiety compared to a transvenous defibrillator in patients requiring an ICD?
p-value: p=0.0007
S-ICD provides similar quality of life to TV-ICD, with potentially lower anxiety and greater reductions in depression over 12 months.
S-ICD-associated anxiety reduction should not yet change device selection; leaves open need for randomized confirmation in ICD candidates.
BACKGROUND: Use of the subcutaneous implantable defibrillator (S-ICD) has increased because the device received US Food and Drug Administration approval in 2012, but we still know little about whether the quality of life (QoL) of patients with an S-ICD versus a transvenous ICD (TV-ICD) is comparable. We compared S-ICD patients with TV-ICD patients on QoL, depression, and anxiety up to 12 months' follow-up. METHODS: A matched cohort of S-ICD (N = 167) and TV-ICD patients (N = 167) completed measures on QoL, depression, anxiety, and personality at baseline, 3, 6, and 12 months post implant. Data were analyzed using multivariable modeling with repeated measures. RESULTS: In adjusted analyses, we found no statistically significant differences between cohorts on physical and mental QoL and depression (all Ps > .05), while S-ICD patients reported lower anxiety than TV-ICD patients (P = 0.0007). Both cohorts experienced improvements in physical and mental QoL and symptoms of depression and anxiety over time (all Ps < .001), primarily between implant and 3 months. These improvements were similar for both cohorts with respect to physical and mental QoL and anxiety (Ps > .05), while S-ICD patients experienced greater reductions in depressive symptoms (P = .0317). CONCLUSION: The QoL and depression levels were similar in patients with an S-ICD and a TV-ICD up to 12 months' follow-up, while S-ICD patients reported lower anxiety levels and a greater reduction in depression over time as compared to TV-ICD patients. This knowledge may be important for patients and clinicians, if the indication for implantation allows both the S-ICD and the TV-ICD, making a choice possible.
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Pedersen et al. (2019) conducted a cohort in Patients requiring an implantable cardioverter defibrillator (ICD) (n=334). Subcutaneous implantable defibrillator (S-ICD) vs. Transvenous implantable defibrillator (TV-ICD) was evaluated on Anxiety over 12 months (p=0.0007). Patients with a subcutaneous ICD reported similar quality of life and depression levels but significantly lower anxiety levels (p=0.0007) compared to a matched cohort with a transvenous ICD over 12 months.
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